Medtronic MiniMed 670G Auto Mode: Implications for Clinical Practice

Abstract Background: The Medtronic MiniMed 670G System was the first FDA approved hybrid closed loop system for users seven years of age and older. The system monitors glucose and can automatically adjust the delivery of long acting or basal insulin based on the user’s glucose reading while in Auto Mode. Previous research has demonstrated that 670G Auto Mode use has improved glycemic control in patients (PTs) with Type 1 diabetes as young as 2 years of age and as old as 75 years of age compared to open loop Manual Mode. Objective: This retrospective study seeks to determine if the results of improved glycemic control, as evidenced by decreased HbA1c levels, can be replicated in real life/uncontrolled environments, when PTs are wearing the 670G system in Auto Mode. Methods: The medical records of PTs prescribed the 670G System at a pediatric endocrinology center were reviewed. PTs who did not use the system in Auto Mode were excluded. PTs who did not have HbA1c values before and at least 3 months after using the 670G system in Auto Mode were also excluded. HbA1c values were collected either as a serum sample at a local laboratory or a capillary sample at the center using Siemens DCA Vantage HbA1c Analyzer. 52 PTs aged 6-25 yrs met these criteria for analysis. Results: When analyzing the PTs as a whole, there was a significant decrease in HbA1c from 8.64% ± 1.51% to 7.81% ± 1.35% (p= 0.024). 63.5% of all PTs showed a decrease in HbA1c. 3.9% of PTs showed no change to their HbA1c. 32.7% of PTs showed an increase in HbA1c. Of those 63.5% of PTs who showed improved glycemic control, 51.5% had data in their charts to reflect their percentage of time in auto mode, which was an average of 54.32% ± 27.28%. There was no significant difference in HbA1c between males and females both prior (p=0.2) and post (p=0.1) treatment, nor was there a significant difference in the mean change of HbA1c between males and females (p=0.50). The PTs who were in auto mode greater than 25% of the time (n=15) showed significantly improved glycemic control with HbA1c levels decreasing from 8.13% ± 1.16% to 7.37% ± 0.58% (P= 0.04). The PTs who were in auto mode greater than 50% of the time (n=10), showed improved glycemic control with HbA1c levels decreasing from 7.87% ± 0.68% to 7.27% ± 0.46% (P= 0.046). There was a significant difference in the mean change of HbA1c between PTs whose adherence was known to be less than 25% (n=9) compared to those whose adherence was known to be greater than 25% (n=15). The difference in mean HbA1c prior treatment was not significant between these groups, yet the difference in mean HbA1c was significant post treatment. Conclusion: Our data demonstrates that the 670G system can significantly improve glycemic control in an uncontrolled environment. Adherence is an important factor in the outcome in this treatment modality. Bluetooth monitoring of patient blood sugar levels may significantly improve adherence and glycemic control.

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Quantitative electroencephalography as a tool for objective neurophysiological seizure diagnosis: A retrospective study

Indian Journal of Medical Sciences ◽

10.25259/ijms_160_2020 ◽

2020 ◽

Vol 0 ◽

pp. 1-6

Author(s):

Rajesh Kumar ◽

Tribhuwan Kumar ◽

Kamlesh Jha ◽

Yogesh Kumar

Keyword(s):

Energy Level ◽

Matched Control ◽

Age Groups ◽

Quantitative Electroencephalography ◽

Beta Band ◽

Significant Difference ◽

Males And Females ◽

The Mean ◽

The Difference ◽

Electrical Activities

Objectives: Seizure is the fourth most common neurological disorder in the world; it affects all age groups with equal possibility of occurrence in both males and females. Many antiepileptic drugs are available today, but its diagnosis is challenging. The present study attempted to see if seizure activities could be predicted by analyzing the pre-seizure electrical activities. The prediction may help in taking preventive measures appropriately beforehand in the individuals with seizure proneness. Material and Methods: We selected 11 generalized seizure patients and 19 control patients out of total 115 patients referred for electro-diagnostics for various reasons. EEG of the subjects recorded, segmented as per protocol, and analyzed using MATLAB and EEGLAB tools. Results: The mean energy level in alpha and beta band of the study subject was significantly lower (P = 0.04 and 0.004, respectively) as compared to the age matched control subjects. Theta and delta bands did not show any significant difference between the groups. The difference between the pre- and post-electrical seizure energy and entropy was statistically insignificant. Conclusion: The study shows that the energy level remains low in the seizure patients in the alpha and beta bands. This further goes down when electrophysiological seizure activities starts. The randomness or entropy does not alter significantly among the seizure subjects in comparison to non-seizure subjects.

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RATING OF THE VALENCE OF TWENTY NEGATIVES IMAGES FROM IAPS BY A SAMPLE OF MOROCCAN NURSE STUDENTS

Acta Neuropsychologica ◽

10.5604/01.3001.0014.4156 ◽

2020 ◽

Vol 18 (3) ◽

pp. 383-391

Author(s):

Lahcen Bandadi ◽

Nadia Chamkal ◽

Ahmed O. T. Ahami

Keyword(s):

Emotional Stimulus ◽

Negative Aspect ◽

First Semester ◽

Negative Valence ◽

Significant Difference ◽

Negative Images ◽

Males And Females ◽

The Mean ◽

The Difference ◽

Nurse Students

This study aims to rate twenty negative images from IAPS among a sample nurse students. We compare the mean valences between males and females and between participants from the final semester and participants from the first semester. The comparison of the mean valences values between the current study and the norm mean valence values from IAPS was established. null We tested 100 students from Higher Institute of Nursing Professions and Technics of Health, Rabat, Morocco, were recruited. The panel valence from SAM was cued to evaluate the perceived pleasure and unpleased degree after exposing the different images from IAPS to the participants. The displeasure degree among nurse students from final semester is lower than that of the first semester with a significant difference in sixteen images. Regarding the difference between males and females, the significant difference was observed only in five images. The all images evaluated by participant were perceived as negative (valence <4). Regarding the comparison of the mean valences values between a the current study and the norm mean valence values from IAPS significant differences were observed. Nurse students from the final semester, compared to the first semester students, perceived the negative images assessed as less unpleasant. However, we noted that the all images have kept the negative aspect. These results show that these images can be used as a negative emotional stimulus among this population.

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Malignancy incidences by glycemic control among diabetic patients

Endocrine Connections ◽

10.1530/ec-18-0355 ◽

2018 ◽

Vol 7 (12) ◽

pp. 1457-1463 ◽

Cited By ~ 3

Author(s):

Daiki Kobayashi ◽

Nagato Kuriyama ◽

Keita Hirano ◽

Osamu Takahashi ◽

Hiroshi Noto

Keyword(s):

Longitudinal Study ◽

Glycemic Control ◽

Time Dependent ◽

Prior History ◽

Diabetic Patients ◽

Mixed Effect ◽

History Of ◽

The Mean ◽

The Difference ◽

Hba1c Levels

Background The aim of this study was to evaluate the difference in malignancy incidence by evaluating time-dependent HbA1c levels among diabetic patients in a longitudinal study. Methods We conducted a retrospective longitudinal study at large academic hospital, Tokyo, Japan, from 2006 to 2016. We included all diabetic patients who were 50 years or older and who underwent health check-ups at the Center for Preventive Medicine. Those patients with a prior history of malignancies were excluded. We categorized patients into five groups on the basis of HbA1c measurements: <5.4, 5.5–6.4, 6.5–7.4, 7.5–8.5, >8.5%. Our primary outcome was the development of any types of malignancy. Longitudinal analyses by a mixed effect model with time-dependent HbA1c levels were applied in order to take into account fluctuations in HbA1c levels within the same patient. Results In total, 2729 participants were included in this study, where the mean age was 62.6 (standard deviation (s.d.): 7.8) and 2031 (74.4%) were male. The mean disease duration of diabetes was 7.6 (s.d.: 7.6) years, and 1688 (61.8%) were prescribed medications. Median follow-up was 1443.5 (interquartile range (IQR): 2508) days and 376 (13.8%) developed malignancies. Compared to the reference range of HbA1c (5.5–6.4%), the odds ratios for developing malignancies among the other HbA1c level groups were similar and not statistically different (OR: 0.98, 95% CI:0.31–3.15 (for HbA1c <5.4%); OR: 0.88, 95% CI: 0.69–1.12 (for HbA1c 6.5–7.4%); OR: 0.88, 95% CI: 0.64–1.22 (for HbA1c 7.5–8.4%); OR 1.07, 95% CI: 0.70–1.66 (for HbA1c >8.5%)). Conclusion In our study, there was no association between glycemic control and the development of future malignancies. Compared to very strictly controlled HbA1c levels, both excessive control and good or bad control had a statistically similar risk of developing malignancies.

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Left Ventricular Dysfunction and Blood Glycohemoglobin Levels in Young Diabetics

Nuklearmedizin ◽

10.1055/s-0038-1629573 ◽

1991 ◽

Vol 30 (05) ◽

pp. 183-188

Author(s):

A. Aydrner ◽

A. Oto ◽

E. Oram ◽

O. Gedik ◽

C. F. Bekdik ◽

...

Keyword(s):

Ejection Fraction ◽

Left Ventricular Function ◽

Ventricular Function ◽

Left Ventricular ◽

Diabetic Patients ◽

Filling Fraction ◽

Time To Peak ◽

Significant Difference ◽

The Mean ◽

Hba1c Levels

Left ventricular function including regional wall motion (RWM) was evaluated by 99mTc first-pass and equilibrium gated blood pool ventriculography and glycohemoglobin (HbA1c) blood levels determined by a quantitative column technique in 25 young patients with insulin-dependent diabetes mellitus without clinical evidence of heart disease, and in healthy controls matched for age and sex. Phase analysis revealed abnormal RWM in 19 of 21 diabetic patients. The mean left ventricular global ejection fraction, the mean regional ejection fraction and the mean 1/3 filling fraction were lower and the time to peak ejection, the time to peak filling and the time to peak ejection /cardiac cycle were longer in diabetics than in controls. We found high HbA1c levels in all diabetics. There was no significant difference between patients with and without retinopathy and with and without peripheral neuropathy in terms of left ventricular function and HbA1c levels.

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Comparative Analysis of Different Local Anesthetic Solutions Available in Market: An In Vitro and Clinical Study

European Journal of Dentistry ◽

10.1055/s-0041-1727553 ◽

2021 ◽

Author(s):

Eisha Imran ◽

Faisal Moeen ◽

Beenish Abbas ◽

Bakhtawar Yaqoob ◽

Mehreen Wajahat ◽

...

Keyword(s):

Comparative Analysis ◽

Local Anesthetic ◽

Compositional Analysis ◽

Bacterial Activity ◽

Similar Composition ◽

Ph Values ◽

Significant Difference ◽

The Mean ◽

The Difference

Abstract Objectives The study aimed to evaluate and compare various commercially available local anesthetic solutions. Materials and Methods A total of 150 commercially available local anesthetic cartridges of similar composition (2% lidocaine with epinephrine 1:100,000) were randomly collected and divided into 3 groups. The designations of groups were selected from their product names such that each group consisted of 60 cartridges. Group S (Septodont, France) Group M (Medicaine, Korea) and Group H (HD-Caine, Pakistan). The samples were divided into five sub-groups, each consisting of 10 cartridges from each group to investigate each parameter. Results The acquired data was statistically analyzed and compared (using SPSS version 12). Compositional analysis revealed a non-significant (P>0.05) difference when the three Groups were compared with standard lidocaine and epinephrine solutions. The mean pH values of samples from group S, M and H respectively fell within the range of pH values of commercially available solutions. Non-significant difference in EPT values of Group S and H was found when efficacy was compared (p = 0.3), however a significant difference (p < 0.01) was observed in contrast to Group M. Anti-bacterial activity was observed in all the group and a non-significant difference in cell viability values of Group S and M was found (p = 0.6), while the difference was significant in comparison to Group H. Conclusion Within the limitations of these investigations, it appears that the properties of different manufacturers fall within the recommended ranges as mentioned in literature and do not appear to be statistically different in the variables we have tested.

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Analysis of the breeding records of a herd of pigs

The Journal of Agricultural Science ◽

10.1017/s0021859600045731 ◽

1954 ◽

Vol 45 (1) ◽

pp. 19-27 ◽

Cited By ~ 10

Author(s):

R. Braude ◽

P. M. Clarke ◽

K. G. Mitchell

Keyword(s):

Statistical Analysis ◽

Large White ◽

Seasonal Differences ◽

Significant Difference ◽

The Mean ◽

The Difference ◽

Length Of Gestation

1. A survey and. statistical analysis of the records of litters born in the N.I.R.D. herd of Large White pigs over a period of 16 years are presented.2. The mean length of gestation was 114 days for both gilts and sows.3. The mean numbers of pigs born alive and born dead per litter from gilts, 10·0 and 0·2 respectively, were both significantly smaller than the corresponding figures for sows, 11·8 and O·8. No seasonal differences were found.4. The mean total losses of pigs from birth to weaning at 8 weeks were 29·5% of pigs born alive. The losses in litters from gilts, 23·0%, were significantly smaller than in litters from sows, 31·0%. The losses during the winter months both for gilts, 32·5%, and for sows, 35·9%, were significantly higher than during the summer months, 19·4% and 26·7% for gilts and sows respectively.5. Over 50% of the total losses were due to crushing by the dam, 74·1% of the losses from this cause occurring during the first 48 hr. after birth.6. The mean number of pigs weaned per litter was 8·0. The difference between the number weaned per litter from gilts, 7·7, and per litter from number of pigs was weaned per litter from sows during the summer months, 8·7, than during the winter months, 7·4.7. There was no significant difference between the number of male and of female pigs weaned.8. The mean weight at weaning was 29·9 lb., male pigs, 30·3 lb., being significantly heavier than females, 29·51b. Pigs in litters from gilts, 27·81b., were significantly lighter at weaning than those from sows, 30·0 lb., and for both gilts and sows, pigs reared during the summer months, 29·7 and 31·8 lb. respectively, were significantly heavier than those reared during the winter months, 25·9 and 28·2 lb. respectively.

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Influence of Apical Patency and Cleaning of the Apical Foramen on Periapical Extrusion in Retreatment

Brazilian Dental Journal ◽

10.1590/0103-6440201302016 ◽

2013 ◽

Vol 24 (5) ◽

pp. 482-486 ◽

Cited By ~ 5

Author(s):

Marili Doro Andrade Deonizio ◽

Gilson Blitzkow Sydney ◽

Antonio Batista ◽

Roberto Pontarolo ◽

Paulo Ricardo Bittencourt Guimarães ◽

...

Keyword(s):

Material Removal ◽

Filling Material ◽

Mean Values ◽

Filtration System ◽

Root Canal Retreatment ◽

Significant Difference ◽

Before And After ◽

The Mean ◽

The Difference ◽

Removal Technique

This study evaluated the influence of apical patency, root filling removal technique and cleaning of the apical foramen, concerning the amount of debris extruded during root canal retreatment. Forty mandibular incisors were randomly assigned to 4 groups - GIM (n=10), GIIM (n=10), GIPT (n=10) and GIIPT (n=10), which were named according to leaving (I) or not (II) apical patency during canal preparation and filling removal technique (manual - M or ProTaper system - PT). After filling material removal, each specimen of each group had the apical foramen cleaned by sizes 15, 20 and 25 instruments, generating 12 subgroups: GIM15, GIM20, GIM25, GIIM15, GIIM20, GIIM25, GIPT15, GIPT20, GIPT25, GIIPT15, GIIPT20 and GIIPT25. Extruded filling debris was collected by a Milipore filtration system, an HV-durapore, 0.45 µm pore filter with a 25 mm diameter. The filters were weighed before and after the collection on an analytical scale (10–5 g), and the difference was calculated. The mean weight of extruded filling debris was analyzed statistically by Kruskal-Wallis and Friedman ANOVA tests (α=0.05). The mean values found in the groups (in mg) were: GIM (0.95±0.94), GIIM (0.47±0.62), GIPT (0.30±0.31) and GIIPT (0.32±0.44). There was no statistically significant difference among any of the groups or subgroups (p>0.05). ProTaper provided the smallest amount of extruded filling material, regardless of presence or absence of apical patency, followed by manual technique, without and with apical patency. Additional amounts of debris were collected during cleaning of the apical foramen, regardless of the instrument, presence/absence of patency or root filling removal technique.

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Abstract 481: Deactivation of the renin-angiotensin-aldosterone system (RAAS) lowers glycated Hemoglobin (HbA1c) in hypertensive patients with Atherosclerotic Renal Artery Stenosis (ARAS)

Hypertension ◽

10.1161/hyp.64.suppl_1.481 ◽

2014 ◽

Vol 64 (suppl_1) ◽

Author(s):

Paola Caielli ◽

Viola Sanga ◽

Raffaella Motta ◽

Michele Battistel ◽

Lorenzo Calò ◽

...

Keyword(s):

Glycemic Control ◽

Medical Therapy ◽

Randomized Clinical Trials ◽

Optimal Medical Therapy ◽

Causative Role ◽

Atherosclerotic Renal Artery Stenosis ◽

Contralateral Kidney ◽

Significant Difference ◽

The Difference

Background: blockade of the RAAS lowered the incidence of Diabetes Mellitus in randomized clinical trials, but whether the de-activation of the RAAS can elicit the same beneficial effect in patients with renovascular hypertension (RVH) is unknown. Aim: to verify if endovascular treatment (EVT) could improve glycemic control in patients with atherosclerotic RVH. Methods: in the METRAS study (http://clinicaltrials.gov/show/NCT01208714, a randomized clinical trial comparing the effect of EVT on top of optimal medical therapy versus medical therapy alone (OMT) on GFR of the ischemic and contralateral kidney in patients with atherosclerotic RVH), glycemic control, as assessed by HbA1c at baseline and repeatedly during follow-up, was a pre-specified secondary endpoint of the study. Results: between June 2010 and March 2014, 16 patients were randomly assigned to EVT plus optimal medical therapy (n = 9) or OMT alone (n = 7). At baseline the 2 groups showed no significant difference of age, clinical and demographical features. All the patients, except two in the EVT group, were on a RAAS blocker. At 2 years follow-up HbA1c increased in patients on OMT (59±12 mmol/mol) from baseline values (45±16 mmol/mol, p<0.001). By contrast, in the patients assigned to EVT HbA1c remained stable (42±7 mmol/mol at baseline vs 41±5 mmol/mol at follow-up; p = NS; p<0.001 vs OMT at follow-up). When analyzed after multivariate adjustment for age, HbA1c at enrollment, and presence/absence of DM, the difference between the arms remained highly significant (p<0.001). Conclusions: in patients with atherosclerotic RVH and chronic activation of the RAAS, deactivation of the RAAS by means of EVT was associated with no increase in plasma levels of HbA1c over long term follow-up. At variance, similar patients assigned to optimized medical therapy alone showed worsened glycemic control over time. These findings support the contention of a causative role of RAAS activation in the incidence/progression of DM.

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Effect of smoking on cardiovascular autonomic functions

International Journal of Physiotherapy and Research ◽

10.16965/ijpr.2021.101 ◽

2021 ◽

Vol 9 (2) ◽

pp. 3780-3784

Author(s):

P.Vani ◽

◽

Sharan B Singh M ◽

Keyword(s):

Heart Rate ◽

Autonomic Function ◽

T Test ◽

Resting Heart Rate ◽

Autonomic Functions ◽

Mean Values ◽

Function Tests ◽

Significant Difference ◽

The Mean ◽

The Difference

Introduction: Cigarette smoking is a prime risk factor for cardiovascular morbidity and mortality. Chronic smoking results in autonomic dysfunction leading to increased cardiovascular risk in smokers. The present study was planned to study the effect of smoking on the Cardiovascular Autonomic Functions among smokers. Materials and Methods: Fifty male subjects who were in the age group of 25 to 45 years. They were grouped into 25 smokers and 25 non-smokers. The participant subjects were selected among the staff members, residents and the patients from the routine OPD in SVIMS. Prior to study, they were informed about the procedure and the purpose of the study tests and written consents were obtained from them. The Cardiovascular Autonomic Function Tests were assessed by using a POLYGRAPH which was available in the department. Results and Conclusion: After applying the ‘t’-test for the difference between the two sample means, it was observed that there was a highly significant difference between the mean values of the BMI(i.e.p<0.01) and the para-sympathetic function tests among the smokers and the non – smokers(i.e.p<0.00). The Resting Heart Rate had significantly increased and the Deep breathing difference, the postural tachycardial index (Response to standing) and the Valsalva Ratio had significantly decreased in the smokers as compared to those in the non – smokers. After applying the ‘t’-test for the difference between the two sample means, it was observed that there was no significant difference between the mean values of the Postural hypotension test (i.e. p>0.05) and that there was a highly significant difference between the mean values of the Sustained handgrip test in the smokers and the non – smokers (i.e. p<0.00). KEY WORDS: Cardiovascular autonomic function tests, Smoking, Resting heart rate.

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The Gender Factor Effect on Saudi Learners’ Perceptions of Using Social Media on Their Social Interaction

English Language Teaching ◽

10.5539/elt.v11n10p30 ◽

2018 ◽

Vol 11 (10) ◽

pp. 30

Author(s):

Boushra Abdul-Aziz AlGhamdi ◽

Shorouq Ali AL-Garni ◽

Maysa M. Qutob

Keyword(s):

Social Media ◽

Social Interaction ◽

Time Management ◽

Real Life ◽

Point Of View ◽

Factor Effect ◽

Males And Females ◽

The Difference ◽

Gender Factor ◽

Positive Point

This study compares males and females perception of the effect of social media on their social interaction to understand the difference between both genders. The study follows a mixed-method methodology using a questionnaire with closed-ended items and open-ended questions. Responses to the questionnaire are collected form 207 male and female students from a public university in Saudi Arabia. In general, the results of the questionnaire are insignificant which indicate that there are no differences between both genders. However, the results of the open-ended questions show that females have a negative view of the effect of social media on human relations while males have a positive point of view. However, both genders have a positive point of view regarding balancing between friends and family in real life and virtual world through time management.

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